Adult III NUR 325 Exam 4 Questions and
Answers Graded A+
Normal Urine output - Correct answer-.5-1 mL/kg/hr
Pre causes of Acute Renal Failure - Correct answer-decreased vascular volume, big
surgeries, CABG, hemorrhage, burns, prolonged V/D, excessive diuresis, CHF, MI,
cardiac dysrhthmias, renal artery stenosis, septic shock, anaphylaxis, decreased
albumin, liver failure
What do we want to keep MAP at to keep up perfusion to the kidneys? - Correct
answer-60 or greater
What do we want to keep systolic BP at to keep up perfusion to the kidneys? -
Correct answer-greater than 90
What are intra causes of acute renal failure? - Correct answer-sustained prerenal
ischemia, glomerulonephritis, acute tubular necrosis, intravenous contrast,
aminoglycosides (gentamycin, tobramycin, vancomycin, NSAIDs, ACE inhibitors)
What are post causes of acute renal failure? - Correct answer-BPH, neoplasms or
trauma, strictures, obstruction of collecting ducts with crystallization
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,Factors for pre-renal ARF - Correct answer-hypoperfusion (decreased systolic and
decreased MAP)
Factors for intra-renal ARF - Correct answer-tissue damage
Factors for post-renal ARF - Correct answer-obstruction of urine flow (BUN a nd
creatinine changes occur)
What antihypertensives are given to help with renal problems? - Correct answer-
ACE, ARB, Ca Cl blockers (in that order)
Phases of ARF - Correct answer-initiation phase, oliguric phase, recovery phase
Initiation phase of ARF - Correct answer-normal kidney response starts to
deteriorate several hours to 2 days
Oliguric phase of ARF - Correct answer-severe biochemical imbalances-
hyperkalemia, increased BUN and creatinine, metabolic acidosis, low Ca and high
phosphate, anemia, urine output up to 400 mL/day
What happens during the oliguric phase for nonoliguric ARF? - Correct answer-
normal UO, but retention of water
What happens during the recovery phase of ARF? - Correct answer-renal tissue
recovers and repairs itself 4-6 months, chemistries return to normal, may have
permanent damage (1-3% reduction in GFB)
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, Av fistula assessment - Correct answer-check for bruit and thrill
Post-dialysis asssessment - Correct answer-get a set of vitals and weight, monitor
for complications (if temp greater than 99.6 suspect sepsis: anticipate blood
cultures), assess for dysrhythmias, hypovolemia, bleeding at access site,
disequilibrium syndrome, hepatitis and other blood borne pathogens, anemia
secondary to ESRD and HD
Dialysis indications - Correct answer-BUN >90mg/dl, serum creatinine >9 mg/dl,
hyperkalemia, drug toxicity, fluid volume excess, metabolic acidosis, uremia,
mental changes (confusion, lethargy, somulence)
Peritoneal dialysis technique - Correct answer-use sterile technique, there is a
permanent catheter surgically placed into the peritoneal space below the umbilicus,
dextrose and fluid are usually warmed for comfort and to prevent hypothermia
Interventions for peritoneal dialysis - Correct answer-clean with soap and water,
make sure there is more output than input!
What is hepatic encephalopathy caused by? - Correct answer-dysfunction of the
liver causing rising ammonia
What labs do you monitor with hepatic encephalopathy? - Correct answer-serum
ammonia (Normal 15-45)
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Answers Graded A+
Normal Urine output - Correct answer-.5-1 mL/kg/hr
Pre causes of Acute Renal Failure - Correct answer-decreased vascular volume, big
surgeries, CABG, hemorrhage, burns, prolonged V/D, excessive diuresis, CHF, MI,
cardiac dysrhthmias, renal artery stenosis, septic shock, anaphylaxis, decreased
albumin, liver failure
What do we want to keep MAP at to keep up perfusion to the kidneys? - Correct
answer-60 or greater
What do we want to keep systolic BP at to keep up perfusion to the kidneys? -
Correct answer-greater than 90
What are intra causes of acute renal failure? - Correct answer-sustained prerenal
ischemia, glomerulonephritis, acute tubular necrosis, intravenous contrast,
aminoglycosides (gentamycin, tobramycin, vancomycin, NSAIDs, ACE inhibitors)
What are post causes of acute renal failure? - Correct answer-BPH, neoplasms or
trauma, strictures, obstruction of collecting ducts with crystallization
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,Factors for pre-renal ARF - Correct answer-hypoperfusion (decreased systolic and
decreased MAP)
Factors for intra-renal ARF - Correct answer-tissue damage
Factors for post-renal ARF - Correct answer-obstruction of urine flow (BUN a nd
creatinine changes occur)
What antihypertensives are given to help with renal problems? - Correct answer-
ACE, ARB, Ca Cl blockers (in that order)
Phases of ARF - Correct answer-initiation phase, oliguric phase, recovery phase
Initiation phase of ARF - Correct answer-normal kidney response starts to
deteriorate several hours to 2 days
Oliguric phase of ARF - Correct answer-severe biochemical imbalances-
hyperkalemia, increased BUN and creatinine, metabolic acidosis, low Ca and high
phosphate, anemia, urine output up to 400 mL/day
What happens during the oliguric phase for nonoliguric ARF? - Correct answer-
normal UO, but retention of water
What happens during the recovery phase of ARF? - Correct answer-renal tissue
recovers and repairs itself 4-6 months, chemistries return to normal, may have
permanent damage (1-3% reduction in GFB)
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
, Av fistula assessment - Correct answer-check for bruit and thrill
Post-dialysis asssessment - Correct answer-get a set of vitals and weight, monitor
for complications (if temp greater than 99.6 suspect sepsis: anticipate blood
cultures), assess for dysrhythmias, hypovolemia, bleeding at access site,
disequilibrium syndrome, hepatitis and other blood borne pathogens, anemia
secondary to ESRD and HD
Dialysis indications - Correct answer-BUN >90mg/dl, serum creatinine >9 mg/dl,
hyperkalemia, drug toxicity, fluid volume excess, metabolic acidosis, uremia,
mental changes (confusion, lethargy, somulence)
Peritoneal dialysis technique - Correct answer-use sterile technique, there is a
permanent catheter surgically placed into the peritoneal space below the umbilicus,
dextrose and fluid are usually warmed for comfort and to prevent hypothermia
Interventions for peritoneal dialysis - Correct answer-clean with soap and water,
make sure there is more output than input!
What is hepatic encephalopathy caused by? - Correct answer-dysfunction of the
liver causing rising ammonia
What labs do you monitor with hepatic encephalopathy? - Correct answer-serum
ammonia (Normal 15-45)
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
